- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,726.71 / $8,521.12 / $13,720.10
| Facility | | $3,726.71 | $8,521.12 | $13,720.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,776.62 / $9,776.62 / $9,776.62
| Facility | | $9,776.62 | $9,776.62 | $9,776.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,899.67 / $11,457.39
| Facility | | $1,474.01 | $4,899.67 | $11,457.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,168.20 / $8,909.39 / $12,621.22
| Facility | | $6,168.20 | $8,909.39 | $12,621.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.69 / $7,472.55 / $15,693.28
| Facility | | $5,391.69 | $7,472.55 | $15,693.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,062.22 / $7,472.55 / $15,895.91
| Facility | | $5,062.22 | $7,472.55 | $15,895.91 |